Teaching Methods Utilized During Medical Resuscitations in an Academic Emergency Department

Abstract

IntroductionOne important skill that an emergency medicine trainee must learn is the resuscitation of the critically ill patient. There is research describing clinical teaching strategies used in the emergency department (ED), but less is known about specific methods employed during actual medical resuscitations. Our objective was to identify and describe the teaching methods used during medical resuscitations.MethodsThis was a prospective study involving review of 22 videotaped, medical resuscitations. Two teams of investigators first each reviewed and scored the amount and types of teaching observed for the same two videos. Each team then watched and scored 10 different videos. We calculated a Cohen’s kappa statistic for the first two videos. For the remaining 20 videos, we determined means and standard deviations, and we calculated independent two-tailed t-tests to compare means between different demographic and clinical situations.ResultsThe Cohen’s kappa statistic was K=0.89 with regard to number of teaching events and K=0.82 for types of teaching observed. Of the resuscitations reviewed, 12 were in coding patients. We identified 148 episodes of teaching, for an average of 7.4 per resuscitation. The amount of teaching did not vary with regard to whether the patient was coding or not (p=0.97), nor based on whether the primary learner was a junior or senior resident (p=0.59). Questioning, affirmatives and advice-giving were the most frequently observed teaching methods.ConclusionTeachers use concise teaching methods to instruct residents who lead medical resuscitations. Further research should focus on the effectiveness of these identified strategies.

Training Leaders in Trauma Resuscitation: Teacher and Learner Perspectives on Ideal Methods

“…9,10 Up to 14 teaching methods have been identified in ED medical resuscitations but have not been studied simultaneouly. 15 We do not know the extent to which informal and interprofessional education aids in acquiring trauma leadership skills, despite the significant role informal curriculum plays in resident education. 16,17 Additionally, the perspectives of both learners and teachers on ideal methods of teaching communication and leadership in trauma resuscitations are not well understood.…”

“… 9 , 10 Up to 14 teaching methods have been identified in ED medical resuscitations but have not been studied simultaneouly. 15 …”

Types and Timing of Teaching During Clinical Shifts in an Academic Emergency Department

“…Indeed, widely varying methods by which expert attendings teach during busy shifts have been described. 10,11 The optimal mode of education in chaotic emergency medicine (EM) environments remains unknown; a more nuanced account of how teaching currently occurs in academic EDs is needed to lay the groundwork for the future study of educational efficacy during shifts.…”